Through the Looking Glass

Friday, October 24, 2003

Lifetime TV has a petition up urging Congress to ban what they call "drive-through" mastectomies, defined as

the practice in which women are forced out of the hospital sometimes only hours after breast cancer surgery ... still in pain, groggy with anesthesia and with drainage tubes still in place

because their insurance companies won't pay for a couple of days in the hospital for recovery.

Let's take a step back. The United States has "market-driven" medical care which isn't really, as most people don't have much of a choice about their insurance provider. Which leads to cases like these in which the insurance companies are unwilling to pay for a decent standard of care -- and both the doctors and patients are stuck.

So, on the one hand, Congress could try to deal with this by restructuring the health care system to change the incentives of the insurance companies, or broadly mandate some general minimal standards of care. But that would involve setting up a regulatory body to manage the details, and we all know how they hate that.

So on the other hand, Congress could do what Lifetime TV is asking them to, and start setting detailed standards of care themselves, for breast cancer... and then what? Every other medical procedure on which the insurance companies are also demanding shoddy care? That wouldn't involve Congress setting up a regulatory body -- it would involve Congress becoming a regulatory body.

But hey, in reproductive medicine at least, the Republican Congress seems to think they already know better than the experts. So, why wouldn't you want them messing around with your AIDS drug regimen?

Thursday, October 23, 2003

Pro-war bloggers have been dealing with all the things going poorly in Iraq by pretending that they're going well -- that Rumsfeld is right that most of the news is good, and that the Western press has been largely ignoring all the wonderful good news. (Never mind that, as Josh Marshall notes, a lot of the "good news" seems to be that we haven't shut down schools and hospitals which Saddam Hussein, at his worst, managed to keep open. In other words, the good news isn't news).

Now comes a memo from Rumsfeld himself which suggests that we may need to seriously rethink our strategy, and ends up its review by saying that -- in Rumsfeld's own words --

It is pretty clear that the coalition can win in Afghanistan and Iraq in one way or another, but it will be a long, hard slog.

Well, what ever will we say about this? Instapundit has a post linking to many, many responses. James Lileks, for instance, suggests that

you could take it to mean “okay, we’ve conquered Afghanistan and Iraq; is there anything else we should be doing?” -- a sentiment which would have seemed quite reassuring to some after 9/11.

Indeed. You could also take it to mean that Rumsfeld doesn't like broccoli. But what it actually says, in Rumsfeld's own words, is that "the coalition" has not yet won in Iraq or Afghanistan, and that winning, while still possible, "will be a long, hard slog".

A more serious and thorough take on the matter is this, from Ogged at Unfogged, who sees "no surprises" in the memo itself, but is shocked, shocked at the way it got spun by USA Today in their first story on it. The complaints (which, in Dave Barry fashion, I am not making up):

Rumsfeld wrote we have "no metrics" to judge progress, which USA Today glossed by saying that we have no "yardstick". Says Ogged: "That is not the same thing: lack of a "yardstick" implies that we don't know what progress or victory would be; lacking a "metric to know," means that we know what we want, but don't know whether we've got it. One implies lack of a plan, the other acknowledges the difficulty of the task." A yardstick sounds like a metric to me.

Rumsfeld wrote, "My impression is that we have not yet made truly bold moves, although we have have made many sensible, logical moves in the right direction, but are they enough?" USA Today summarizes by saying that "we have not made any truly bold moves", quoting Rumsfeld directly -- and Ogged pretends that's a sneaky way for them to distort the memo into a claim we've done nothing. It isn't. The real news here is that Rumsfeld doesn't seem to think that deposing two governments, both supposedly in the service of the War on Terror, are "bold moves"... but I digress.

Rumsfeld wrote the bit above about "a long, hard slog", and USA Today put that in the lead; no surprise, considering that it gives the lie to all his public happy talk. Ogged thinks that's bad. He doesn't say why; it's just bad.

And so forth. Insty links to quite a few others, and it's not worth going through all of them. There is one line of argument that occurs in several, though, which is worth a bit of comment. It's that the memo asks probing questions, and asking probing questions is good, so the memo is good, therefore everything's still all good. Um... no. Rumsfeld has been trying to make you believe things are good, but the memo says that things are bad, and asks probing questions about why they're bad. That means even Rumsfeld thinks things are bad, no matter how much he'd like you to believe something else. Please make a note of it.

It's been a while since I've done one of these, but Ad peeve du jour: "Only this truck has earned the right to be the next F-150." Yep. All the other trucks were competing for the right to be the next Hummer...

Wednesday, October 22, 2003

John Tierney, in his New York Times letter from Iraq, puts his finger on the really important question:

Pollsters and journalists have been busy asking Iraqis how they feel about the Americans on their streets, but there is a potentially more important issue. How do the Americans here feel about the Iraqis?

The most significant thing about the various problems he goes on to describe -- Americans giving offense by not understanding local customs, or even the language, and the frustration that engenders on both sides -- is not that they signify American unpreparedness, or suggest an urgent need for assistance from someone else who has a frigging clue, but rather that they might keep the Americans from "feel[ing] comfortable enough in this alien culture to finish the job they started".

Sometimes you wonder exactly where defenders of Dubya's crew are getting their information. That would certainly be the case with William Safire's column this morning. He actually says Kurdish leader Massoud Barzani is opposing the introduction troops only because unspecified "Iraqi Arabs [are] using ... Barzani as their wedge to evoke faded memories of the Ottoman Empire and to look the Turkish gift horse in the mouth."

Safire neglects the possibility that the Kurds might have their own reasons for opposing the introduction of Turkish troops... like, oh, say, several years' worth of Turkish raids on their territory, bombing of their villages, and so forth. The Turks describe these as hot pursuit of a guerilla force made up of oppressed Turkish Kurds, the PKK, but as you might imagine, that's pretty slim comfort to the victims even when it's true, which has certainly been debatable. And it's no secret that the Turkish government was seeking control of what Kurds consider their territory, including in particular the oilfields around Kirkkuk, as a payoff for combat support in what tbogg calls Operation Inigo Montoya, before those negotiations broke down.

So, the suggestion that an Iraqi Kurd would need motivation from anyone else to oppose the introduction of Turkish troops is laughable. In fact, I can't recall a similar demonstration of blank ignorance of the Iraqi ethnic mix since Paul Wolfowitz claimed that "there was no history of ethnic strife in Iraq, as there was in Bosnia or Kosovo." Which brings us back to the question of where the well-connected Safire is getting his information. Is it possible that "Wolfowitz of Arabia" is still so utterly clueless?

Which is not to say that Iraqi Arabs support the introduction of Turkish troops, as Riverbend, one of their number, explains in her usual lucid style...

BTW, an embarassing and obvious typo ("Kurdish" for "Turkish") has been corrected here...

Tuesday, October 21, 2003

Calpundit comments on
the California supermarket strike-cum-lockout, noting, among other
things, that

if corporations -- or entire industries -- are routinely
allowed to bargain on behalf of a large number of owners and
shareholders while workers are allowed to represent only themselves,
no honest bargain is possible. Individual workers have no leverage in
such a situation, and wages are inexorably pushed to subsistence
levels.

(Which is an old argument -- see below -- but I digress).

Regarding supermarket workers, though, there's a bit of a problem
-- it isn't so much that the handwriting is on the wall for them, as
that the self-service checkout stations are on the floor, slowly
creeping into several Shaw's owned supermarkets around here. There
aren't very many yet, but we've all seen how these trends start. (In
response to this point in his comments, the Calpundit himself notes
that shelf-stocking jobs aren't going away soon. It's more proper to
say that they aren't going away yet -- autonomous robots are
getting cheaper and more capable, and "empty pallet x onto shelf y"
isn't that hard a job. Not now, not next year, but in ten years or so
automated restocking is likely to be cost-effective, even cheap).

So, sooner or later, those supermarket workers are all going to
need another job, in a different industry. And their union isn't
exactly well positioned to help them get it, since it is a food
service workers' union, tied to the jobs that are going away. Which
is a particular instance of a general problem -- our unions right now
are trade unions, which work only for the benefit of the
members of the union, and not for the benefit of the labor force as a
whole. Which can lead to deals that injure the interests of other
workers -- sometimes even other workers for the same company, as in
the sadly common union contracts which give new hires a different,
lower pay scale than current union members. Just as seriously, it can
add inefficiency to unionized business, as the unions insist on
maintaining unnecessary positions, obsolete work rules, and so forth,
to benefit their workers, at the inevitable expense of the customers
of the business and the economy as a whole.

It would be nice if they took a broader view -- heck, it would be
nice if management took a broader view, as Toyota has, trying to find
new business to find new business for plants and even subcontractors which it
expects to be running short of work in coming years -- but in America, that
may be too much to ask. (Indeed, things were actually worse at the
turn of the last century, when many nascent unions were openly
racist).

Another alternative is for some broader force -- say, the
government -- to do something to defend the interest of the work force
as a whole -- say, passing minimum wage laws -- in order to defend the
interests of the workers in a manner that doesn't set up distorting
effects between one sector and another. Which was one of Franklin
Roosevelt's ideas in the New Deal. Expounding the kind of conservatism
that runs our government these days, it seems Bob Bartley doesn't
like it, though as usual for commentators of his ilk, he isn't letting the
facts get in the way of a good argument. But I'm guessing, he isn't really thrilled with labor
unions either.
So, how to defend the interests of the workers?

Well, here, once again, is Adam
Smith, from the
Wealth of Nations, on what things are like when the workers have
no defense, speaking of current conditions in the Britain of his day
when labor unions were effectively banned:

What are the common wages of labour, depends everywhere upon the
contract usually made between those two parties, whose interests are
by no means the same. The workmen desire to get as much, the masters
to give as little as possible. The former are disposed to combine in
order to raise, the latter in order to lower the wages of labour.

It is not, however, difficult to foresee which of the two parties
must, upon all ordinary occasions, have the advantage in the dispute,
and force the other into a compliance with their terms. The masters,
being fewer in number, can combine much more easily; and the law,
besides, authorizes, or at least does not prohibit their combinations,
while it prohibits those of the workmen. We have no acts of parliament
against combining to lower the price of work; but many against
combining to raise it. In all such disputes the masters can hold out
much longer. ...

We rarely hear, it has been said, of the combinations of masters,
though frequently of those of workmen. But whoever imagines, upon this
account, that masters rarely combine, is as ignorant of the world as
of the subject. Masters are always and everywhere in a sort of tacit,
but constant and uniform combination, not to raise the wages of labour
above their actual rate. To violate this combination is everywhere a
most unpopular action, and a sort of reproach to a master among his
neighbours and equals. We seldom, indeed, hear of this combination,
because it is the usual, and one may say, the natural state of things,
which nobody ever hears of. Masters, too, sometimes enter into
particular combinations to sink the wages of labour even below this
rate. These are always conducted with the utmost silence and secrecy,
till the moment of execution, and when the workmen yield, as they
sometimes do, without resistance, though severely felt by them, they
are never heard of by other people.

Maybe Bartley thinks that a return to those days would be a good
idea.

Sunday, October 19, 2003

Back when welfare "reform", forcing single women back into the work
force, was passed under Clinton, the harshest critics weren't worried
so much about what would happen immediately, as what would happen
after the next downturn when the job market dried up. Well, we're in
the next downturn, the jobs have dried up, and as Matt Yglesias points
out, loud advocates of this policy are suddenly
quiet.

But let's look at a case where it worked. Kim Braithwaite was a
working mom who had managed to get a decent job at McDonald's (no mean
feat), but one that required her to work crazy shifts. About a week
ago, her babysitter didn't show up, and fearful of losing her job, she
left her two children, nine years old and one, alone in her apartment,
where they perished in a fire. She is now on trial
for child neglect. The prosecutors say, "our position is we had
to charge -- two babies are dead." They don't seem to have any idea
what she could have done instead -- would it really be more
responsible to lose the job and let the kids go hungry? -- but they
don't have to have one. It's Ms. Braithwaite's fault she couldn't
find a job which would allow her to pay for reliable child care,
whether or not that job even exists.